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New AAP guideline recommends insulin, metformin at diagnosis for type 2 diabetes in youths


In children and adolescents with type 2 diabetes, insulin should be initiated first if random blood glucose concentrations are at least 250 mg/dL or hemoglobin A1C (A1C) is >9%, according to a new clinical practice guideline. In all others, lifestyle modifications and metformin should be initiated at diagnosis.


Copeland KC et al. Management of newly diagnosed type 2 diabetes mellitus (T2DM) in children and adolescents. Pediatrics. 2013;131:364–82.